Prevalence and management of familial hypercholesterolaemia in patients with acute coronary syndromes.

AIMS: We aimed to assess the prevalence and management of clinical familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). METHODS AND RESULTS: We studied 4778 patients with ACS from a multi-centre cohort study in Switzerland. Based on personal and familial history of premature cardiovascular disease and LDL-cholesterol levels, two validated algorithms for diagnosis of clinical FH were used: the Dutch Lipid Clinic Network algorithm to assess possible (score 3-5 points) or probable/definite FH (>5 points), and the Simon Broome Register algorithm to assess possible FH. At the time of hospitalization for ACS, 1.6% had probable/definite FH [95% confidence interval (CI) 1.3-2.0%, n = 78] and 17.8% possible FH (95% CI 16.8-18.9%, n = 852), respectively, according to the Dutch Lipid Clinic algorithm. The Simon Broome algorithm identified 5.4% (95% CI 4.8-6.1%, n = 259) patients with possible FH. Among 1451 young patients with premature ACS, the Dutch Lipid Clinic algorithm identified 70 (4.8%, 95% CI 3.8-6.1%) patients with probable/definite FH, and 684 (47.1%, 95% CI 44.6-49.7%) patients had possible FH. Excluding patients with secondary causes of dyslipidaemia such as alcohol consumption, acute renal failure, or hyperglycaemia did not change prevalence. One year after ACS, among 69 survivors with probable/definite FH and available follow-up information, 64.7% were using high-dose statins, 69.0% had decreased LDL-cholesterol from at least 50, and 4.6% had LDL-cholesterol ≤1.8 mmol/L. CONCLUSION: A phenotypic diagnosis of possible FH is common in patients hospitalized with ACS, particularly among those with premature ACS. Optimizing long-term lipid treatment of patients with FH after ACS is required.

Ammatti-identiteetin rakentuminen sairaanhoitajilla

Ammatti-identiteetti luo pohjan henkilön ammattitaidolle, oman, henkilökohtaisen ammatillisen osaamisen arvostamiselle sekä koko ammattikuvalle, sille millaisena työntekijänä jokainen itsensä näkee. Vahva ammatti-identiteetti aikaansaa positiivisen takaisinkytkennän, kun hyvin tehdyn työn seurauksena saadaan kannustavaa palautetta, mikä kasvattaa itsetuntoa, joka puolestaan luo positiivinen omakuvan, jonka seurauksena syntyy vahva ammatti-identiteetti. Tämän tutkimuksen tarkoituksena on selvittää millä tavoin ammatti-identiteetti rakentuu ja muotoutuu, ja millaisia ovat sitä muovaavat tekijät. Samalla pyritään selvittämään millainen merkitys ammatti-identiteetillä on työn suorittamiseen, työssä viihtymiseen sekä omaan näkemykseen itsestään tietyn alan ammattilaisena. Tutkimuksen kontekstina on terveydenhoitoala, ja empiriassa tutkitaan sairaanhoitajien ammatti-identiteettiä. Tutkimuksen perusteella näyttää siltä, että sairaanhoitajat arvostavat ammattiaan ja ammattitaitoaan huolimatta yhteiskunnallisesta aliarvostuksesta. Tämä tukee käsitystä sairaanhoitajien vahvasta ammatti-identiteetistä. Tutkimuksen tulokset osoittavat, että sairaanhoitajan ammatti-identiteetti on moniulotteinen ilmiö. Ammatti-identiteetti ei ole irrallinen henkilön persoonallisesta identiteetistä, vaan ne tukevat toinen toistaan.

Confirmatory factor analysis of an inventory of perception of insecurity and fear of crime

This paper focuses on the study of the factorial structure of an inventory to estimate the subjective perception of insecurity and fear of crime. Made from the review of the literature on the subject and the results obtained in previous works, this factor structure shows that this attitude towards insecurity and fear of crime is identified through a number of latent factors which are schematically summarized in (a) personal safety, (b) the perception of personal and social control, (c) the presence of threatening people or situations, (d) the processes of identity and space appropriation, (e) satisfaction with the environment, and (f) the environmental and the use of space. Such factors are relevant dimensions to analyze the phenomenon. Method: A sample of 571 participants in a neighborhood of Barcelona was evaluated with the proposed inventory, which yielded data from the distributions of all the items provided. The administration was conducted by researchers specially trained for it and the results were analyzed by using standard procedures in the confirmatory factor analysis (CFA) from the hypothesized theoretical structure. The analysis was performed by decatypes according to the different response scales prepared in the inventory and their ordinal nature, and by estimating the polychoric correlation coefficients. The results show an acceptable fit of the proposed model, an appropriate behavior of the residuals and statistically significant estimates of the factor loadings. This would indicate the goodness of the proposed factor structure.

Attitudes and burden in relatives of patients with schizophrenia in a middle income country

BACKGROUND: Most studies of family attitudes and burden have been conducted in developed countries. Thus it is important to test the generalizability of this research in other contexts where social conditions and extended family involvement may be different. The aim of this study was to assess the relationship between the attitudes of caregivers and the burden they experience in such a context, namely Arica, a town located in the northernmost region of Chile, close to the border with Peru and Bolivia. METHODS: We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components) and burden (including subjective distress, rejection and competence) in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica. RESULTS: Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers) exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000).This was also the case for caregivers with a low educational level (t = 3.27; p < 0.003), for the oldest caregivers (r = 0.546; p = 0.000) and for those who had spent more time with the patient (r = 0.377; p = 0.015). Although attitudes had significant association with burden, their explanatory power was modest (R2 = .104, F = 4,55; p = .039). CONCLUSIONS: Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context.

Prevalence and determinants of periodic limb movements in the general population.

OBJECTIVE: Periodic limb movements during sleep (PLMS) are sleep phenomena characterized by periodic episodes of repetitive stereotyped limb movements. The aim of this study was to describe the prevalence and determinants of PLMS in a middle to older aged general population. METHODS: Data from 2,162 subjects (51.2% women, mean age = 58.4 ± 11.1 years) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Assessments included laboratory tests, sociodemographic data, personal and treatment history, and full polysomnography at home. PLMS index (PLMSI) was determined, and PLMSI > 15/h was considered as significant. RESULTS: Prevalence of PLMSI > 15/h was 28.6% (31.3% in men, 26% in women). Compared to subjects with PLMSI ≤ 15/h, subjects with PLMSI > 15/h were older (p < 0.001), were predominantly males (p = 0.007), had a higher proportion of restless legs syndrome (RLS; p < 0.001), had a higher body mass index (p = 0.001), and had a lower mean glomerular filtration rate (p < 0.001). Subjects with PLMSI > 15/h also had a higher prevalence of diabetes, hypertension, and beta-blocker or hypnotic treatments. The prevalence of antidepressant use was higher, but not statistically significant (p = 0.07). Single nucleotide polymorphisms (SNPs) within BTBD9 (rs3923809), TOX3 (rs3104788), and MEIS1 (rs2300478) genes were significantly associated with PLSMI > 15/h. Conversely, mean hemoglobin and ferritin levels were similar in both groups. In the multivariate analysis, age, male gender, antidepressant intake, RLS, and rs3923809, rs3104788, and rs2300478 SNPs were independently associated with PLMSI > 15/h. INTERPRETATION: PLMS are highly prevalent in our middle-aged European population. Age, male gender, RLS, antidepressant treatment, and specific BTBD9, TOX3, and MEIS1 SNP distribution are independent predictors of PLMSI > 15/h. ANN NEUROL 2016;79:464-474.

El desarrollo personal y profesional mediante el aprendizaje reflexivo : una experiencia en el grado de Educación Social

In the last years, an increase of the interest to develop educational practices in higher education, based on the approach of the reflective learning, is observed. Nevertheless, we scarcely find in our context researches or experiences that allow knowing students’ perceptions about this teaching and learning approach. We have developed an experience in the bachelor of Social Education at the University of Girona with the aim to contribute to the personal and professional development of future social educators in their initial training, using reflective learning methodology. In this article we present an evaluation of the experience based on students’ perceptions. They assessed the usefulness they think the module has for their training, the methodology and the activities. This evaluation has been carried out through in-depth interviews to 17 students who participated in the module in 2010-11 academic year. The results show that students assess positively the experience, either its general usefulness or the methodology of reflective learning, although they acknowledge some difficulties to carry out such a process which involves a high degree of introspection and a difficulty to set the boundaries in the narration of personal questions. The study also shows some challenges related on the need, but also the difficulty, to include personal and professional development as a powerful axis in the higher education curriculum, as well as elements linked to reflective learning assessment

Mycobacterium tuberculosis Infection in Young Children: Analyzing the Performance of the Diagnostic Tests

This study evaluated the performance of the Tuberculin Skin Test (TST) and Quantiferon-TB Gold in-Tube (QFT) and the possible association of factors which may modify their results in young children (0-6 years) with recent contact with an index tuberculosis case. Materials and Methods: A cross-sectional study including 135 children was conducted in Manaus, Amazonas-Brazil. The TST and QFT were performed and the tests results were analyzed in relation to the personal characteristics of the children studied and their relationship with the index case. Results: The rates of positivity were 34.8% (TST) and 26.7% (QFT), with 14.1% of indeterminations by the QFT. Concordance between tests was fair (Kappa = 0.35 P<0.001). Both the TST and QFT were associated with the intensity of exposure (Linear OR = 1.286, P = 0.005; Linear OR = 1.161, P = 0.035 respectively) with only the TST being associated with the time of exposure (Linear OR = 1.149, P = 0.009). The presence of intestinal helminths in the TST+ group was associated with negative QFT results (OR = 0.064, P = 0.049). In the TST- group lower levels of ferritin were associated with QFT+ results (Linear OR = 0.956, P = 0.036). Conclusions: Concordance between the TST and QFT was lower than expected. The factors associated with the discordant results were intestinal helminths, ferritin levels and exposure time to the index tuberculosis case. In TST+ group, helminths were associated with negative QFT results suggesting impaired cell-mediated immunity. The TST-&QFT+ group had a shorter exposure time and lower ferritin levels, suggesting that QFT is faster and ferritin may be a potential biomarker of early stages of tuberculosis infection.

eLab, a Personal Learning Environment for the Green Open Innovation Platform

Open Innovation is a relatively new concept which involves a change of paradigm in the R+D+i processes of companies whose aim is to create new technologies or new processes. If to this change, we add the need for innovation in the new green and sustainability economy, and we set out to create a collaborative platform with a learning space where this can happen, we will be facing an overwhelming challenge which requires the application of intelligent programming technologies and languages at the service of education.The aim of the Green IDI (Green Open Innovation) ¿ Economic development and job creation vector in SMEs, based on the environment and sustainability project is to create a platform where companies and individual researchers can perform open innovation processes in the field of sustainability and the environment.The Green IDI (Green Open Innovation) project is funded under the program INNPACTO by the Ministry of Science and Innovation of Spain and is being developed through a consortium formed by the following institutions: GRUPO ICA; COMPARTIA; GRUPO INTERCOM; CETAQUA and the Instituto de Investigación en Inteligencia Artificial (IIIA) from Consejo Superior de Investigaciones Científicas (CSIC). Also the consortium include FUNDACIÓ PRIVADA BARCELONA DIGITAL; PIMEC and UNIVERSITAT OBERTA DE CATALUNYA (UOC).Sustainability and positive action for the environment are considered the principle vector of economic development for companies. As Nicolás Scoli says (2007) ¿in short, preventing unnecessary consumption and the efficient consumption of resources means producing greater wealth with less. Both effects lead to reduced pollution linked to production and consumption¿.The Spanish Sustainable Development Strategy (EEDS) plan defends consumption and sustainable production linked to social and economic development by adhering to the commitment not to endanger ecosystems and abolishing the idea that economic growth is directly proportional to the deterioration of the environment.Uniting the Open Innovation and New Green Economy concepts leads to the "Green Open Innovation¿ Platform creation project.This article analyses the concept of open innovation and defines the importance of the new green and sustainable economy. Lastly, it proposes the creation of eLab. The eLab is defined as an Open Green Innovation Platform personal and collaborative education space which is fed by the interactions of users and which enables innovation processes based on new green economy concepts to be carried out.The creation of a personal learning environment such as eLab on the Green Open Innovation Platform meets the need to offer a collaborative space where platform users can improve their skills regarding the environment and sustainability based on collaborative synergies through Information and Communication Technologies.

Minimum-uncertaity states and pseudoclassical dynamics. II

The set of initial conditions for which the pseudoclassical evolution algorithm (and minimality conservation) is verified for Hamiltonians of degrees N (N>2) is explicitly determined through a class of restrictions for the corresponding classical trajectories, and it is proved to be at most denumerable. Thus these algorithms are verified if and only if the system is quadratic except for a set of measure zero. The possibility of time-dependent a-equivalence classes is studied and its physical interpretation is presented. The implied equivalence of the pseudoclassical and Ehrenfest algorithms and their relationship with minimality conservation is discussed in detail. Also, the explicit derivation of the general unitary operator which linearly transforms minimum-uncertainty states leads to the derivation, among others, of operators with a general geometrical interpretation in phase space, such as rotations (parity, Fourier).

Aprendizaje y servicio: estudio del grado de satisfacción de estudiantes universitarios

El aprendizaje y servicio es una metodología pedagógica que fomenta el aprendizaje de los estudiantes mediante su participación activa en experiencias asociadas al servicio comunitario. Esta metodología permite al estudiante involucrarse directamente con aquellos a quienes ofrece un servicio, adaptándose a sus necesidades y a una realidad que a menudo es muy diferente de la que vive en el aula. En esto radica uno de sus mayores impactos. Además, este tipo de prácticas contribuye a despertar en los alumnos su interés por la acción colectiva, su formación ciudadana, etc. La investigación que se presenta ha consistido en un estudio diagnóstico- comprensivo con 39 estudiantes, donde a partir del modelo de satisfacción con el que se ha trabajado se han analizado cuatro dimensiones clave (conocimiento e intención atribuida, valoración de la utilidad atribuida, valoración del proceso y proyección social). Estas dimensiones nos han conducido a reflexionar sobre elementos claves del aprendizaje y servicio (aprendizajes ciudadanos, aprendizajes personales, aprendizajes curriculares, procesos de reflexión, etc.). La muestra del estudio ha estado formada por 39 estudiantes y la principal técnica de análisis de la información recogida ha sido el análisis de contenido, mediante la triangulación de técnicas (cuestionario, entrevista y grupos de discusión) e informantes (estudiantes, profesores, coordinadores y miembros de entidades). El análisis de la información muestra un alto grado de satisfacción de los alumnos participantes. La dimensión que ha influido más en este resultado ha sido la valoración de la utilidad atribuida; en concreto, la percepción que tienen los alumnos sobre la adquisición de unos aprendizajes conceptuales, personales y ciudadanos. Atendiendo a lo anterior, cabe señalar que la relación generada entre profesores, entidades y estudiantes, así como la posibilidad de vincular la teoría con la práctica han condicionado los resultados. -------------------------------------------------------------------------------------------- Service learning projects promote student learning through active participation in community service. Thus, the service learning method enables students to engage directly with the people to whom they offer their services and requires them to adapt to other peoples' needs and to a reality that is often very different from the classroom. This is one of the major ways in which service learning has an impact. In addition, service learning helps to awaken students' interest in collective action, citizenship, etc. A comprehensive diagnostic study of 39 students was conducted to analyse four key dimensions (attributed knowledge and intentionality, evaluation of usefulness, evaluation of the process and social impact) on the basis of the chosen satisfaction model. The four dimensions led to reflection on key elements of learning and community service (learning about citizenship, learning about oneself, learning of a curriculum, processes of reflection, etc.). The main data analysis technique was content analysis, involving the triangulation of various techniques (questionnaires, interviews and discussion groups) and informants (students, teachers, coordinators and members of other organisations). Data analysis showed a high degree of satisfaction among the participating students. The dimension that most influenced the results was assessment of the attributed value, more specifically the students' perception of their acquisition of conceptual, personal and citizenship knowledge. It should be cautioned that the results were swayed by the relationship generated among teachers, students and institutions and the possibility of linking theory with practice.

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

INTRODUCTION: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. METHODS: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. DISCUSSION: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.

Hospital doctors' views and concerns about pharmacovigilance

Purpose: The aim of the study was to evaluate the opinions and concerns of hospital doctors about adverse drug reactions (ADRs) and pharmacovigilance. Methods: A qualitative study was undertaken using focus groups in sessions on pharmacovigilance activities conducted in thirteen clinical services of a tertiary university hospital. A total of 296 physicians participated in these sessions by giving their opinions or expressing their doubts about ADR and pharmacovigilance activities which were recorded by different observers and subsequently analysed. Results: Doctors remarked on: a) the importance, concern, frequency and specific types of ADRs that were observed in clinical practice; b) problems of clinical decision making related to the suspected ADRs; c) methods for improving detection and reporting ADRs; d) monitoring of specific ADRs or ADRs caused by specific drugs; e) and measures to prevent and minimize the risk of ADRs. Physicians expressed doubts related to: a) the basic concepts of ADRs; b) the methods of ADR identification and evaluation; c) the objectives and procedures of pharmacovigilance programmes; d) and the impact of pharmacovigilance activities. Conclusions: Hospital doctors believe that ADRs are a matter for concern in their daily clinical practice, and monitoring ADRs as well as measures for preventing the risk of ADRs are needed. Nevertheless, doctors have doubts about what an ADR is, the accuracy of diagnostic methods, the development of pharmacovigilance activities and their impact on clinical practice. Pharmacovigilance should be better explained through a continuous feedback and close relationship with hospital doctors.

Joseph Neng Shun Kwong: a famous and obscure scientist

Many students and professionals in chemistry and chemical engineering related the name Kwong with one of the most remarkable equations of state with two parameters. In the same way, very few people know who Kowng was. This article shows some of the unknown personal and professional facts of Joseph Neng Shun Kwong, a person who devoted almost four decades of his life to the industrial research in the adhesives industry.

Condiciones de trabajo psicosociales y desgaste psíquico en trabajadores de diversos sectores empresariales de centro-oriente, suroccidente y región Caribe en Colombia

Objetivo: Determinar la percepción de trabajadores de distintos sectores empresariales de Colombia sobre los factores psicosociales presentes en su entorno laboral y la relación entre los factores psicosociales nocivos y los síntomas subjetivos y alteraciones de la salud. Materiales y métodos: Estudio no experimental, transversal y cuantitativo. Participaron 370 trabajadores, de diferentes sectores empresariales de Colombia (Centro-Oriente, Suroccidente y región Caribe). Instrumento: batería para el estudio de las condiciones de trabajo de carácter psicosocial (CTCPS-MAC), validada para población iberoamericana, permite evaluar cuatro dimensiones: Contexto de trabajo, Contenido de trabajo, Factores individuales y Desgaste psíquico e incluye catorce factores psicosociales. Los datos se analizaron con IBM SPSS statistics 21. Se realizó análisis bivariado y regresión logística multivariante de factores psicosociales nocivos y desgaste psíquico. Resultados: Los factores formación, baja médica, contexto de trabajo, contenido de trabajo y factores individuales están asociados en este estudio con desgaste psíquico. El contexto de trabajo es la variable que infiere mayor riesgo (p=0.000; Exp (B)= 5.355) para provocar desgaste psíquico, seguida de la formación técnica o superior y del contenido del trabajo. Conclusiones: Si bien aquellos trabajadores cuya percepción nociva del contexto de trabajo (interrelación trabajo-vida familiar/personal, cultura de la organización, gestión de la empresa, etc.), del contenido de trabajo (concepción tareas, carga y ritmo de trabajo, etc.) y los que tienen formación técnica o superior tienen mayor probabilidad de padecer desgaste psíquico, se observan aspectos positivos de las condiciones de trabajo psicosocial y su influencia en los trabajadores y en las organizaciones.

Virtuaalinen yhteisöllisyys ja siihen vaikuttavat tekijät

Virtuaalista yhteisöllisyyttä ja virtuaaliyhteisöissä tapahtuvaa osallistumista yhdistävää empiiristä tutkimusta ei ole toistaiseksi raportoitu tieteellisessä tutkimuksessa. Tässä tutkimuksessa tutkittiin ja analysoitiin virtuaalisen yhteisöllisyyden ja virtuaalisen osallistumisen sekä virtuaaliseen osallistumiseen vaikuttavien tekijöiden suhteita yksilön näkökulmasta virtuaaliyhteisössä. Tutkimuksen tavoitteena oli selvittää yksilön virtuaalisen yhteisöl-lisyyden kokemusta ja siihen vaikuttavia tekijöitä. Toisena keskeisenä tutkimustavoitteena oli tarkastella yksilön odottamien etujen vaikutusta yksilön osallistumiseen virtuaaliyhteisössä. Tutkimus toteutettiin tapaustutkimuksena ja tutkimuskohteena oli erään mediayrityksen ylläpitämä virtuaaliyhteisö. Tutkimuksen empiirinen osa toteutettiin strukturoituna verkkokyselynä, josta saatu aineisto analysoitiin kvantitatiivisia menetelmiä käyttäen. Tärkeimpänä tutkimuksellisena havaintona todettiin yksilön viestejä lukemalla tapahtuvan virtuaalisen osallistumisen vaikuttavan voimakkaammin yksilön kokemaan virtuaalisen yhteisöllisyyden tunteeseen kuin yksilön viestejä kirjoittamalla tapahtuvan osallistumisen. Yksilön odottamien etujen havaittiin myös poikkeavan lukemalla tai kirjoittamalla osallistuvien kohdalla. Henkilöt jotka osallistuivat virtuaaliyhteisöön viestejä lukemalla, toivoivat kognitiivisia, sosiaalisia ja hedonistisia etuja. Henkilöt jotka osallistuivat viestejä kirjoittamalla, toivoivat henkilökohtaisia, sosiaalisia ja hedonistia etuja. Henkilön sukupuolella, virtuaaliyhteisöstä saadun tiedon tarpeella ja sanomalehden tilaustottumuksilla havaittiin olevan vaikutusta yksilön osallistumisestaan toivomiin etuihin, virtuaalisen yhteisöllisyyden kokemukseen ja osallistumiseen virtuaaliyhteisöissä.